Prognostic significance of night-time, early morning, and daytime blood pressures on the risk of cerebrovascular and cardiovascular mortality: The Ohasama Study

Hirohito Metoki, Takayoshi Ohkubo, Masahiro Kikuya, Kei Asayama, Taku Obara, Azusa Hara, Takuo Hirose, Junichiro Hashimoto, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Yutaka Imai

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Abstract

OBJECTIVE: To clarify whether high blood pressure (BP) at a particular time of day is associated with cerebrovascular and cardiovascular mortality risk. METHODS: Cerebrovascular and cardiovascular mortality in 1360 individuals aged 40 years and older in Ohasama, Japan, was followed for an average of 10.6 years. We used 2-h moving averages of the BP (a total of 24 average BP measurements for two consecutive hours based on four BP readings taken every 30 min) to compare the predictive power of BP taken during a 24-h period given the same number of measurements. The associations between cerebrovascular and cardiovascular mortality risk and the 2-h moving averages of systolic blood pressure (2 h-SBP) recorded over 24 h were analysed using a Cox proportional hazards model after adjusting for possible confounding factors. RESULTS: The total cerebrovascular and cardiovascular mortality risk was significantly associated with elevated 2 h-SBP recorded during the night and early morning periods. Haemorrhagic stroke mortality was significantly associated with elevated daytime 2 h-SBP. Cerebral infarction mortality and heart disease mortality were significantly associated with elevated night-time 2 h-SBP. CONCLUSION: High BP at different times of day were associated with different subtypes of cerebrovascular and cardiovascular mortality risk.

Original languageEnglish
Pages (from-to)1841-1848
Number of pages8
JournalJournal of hypertension
Volume24
Issue number9
DOIs
Publication statusPublished - 2006 Sep

Keywords

  • Blood pressure
  • Cardiovascular disease
  • Cerebrovascular disorders
  • Circadian rhythm
  • Population

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Metoki, H., Ohkubo, T., Kikuya, M., Asayama, K., Obara, T., Hara, A., Hirose, T., Hashimoto, J., Totsune, K., Hoshi, H., Satoh, H., & Imai, Y. (2006). Prognostic significance of night-time, early morning, and daytime blood pressures on the risk of cerebrovascular and cardiovascular mortality: The Ohasama Study. Journal of hypertension, 24(9), 1841-1848. https://doi.org/10.1097/01.hjh.0000242409.65783.fb